Colorado
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Title Publication Category Date

Clinical Laboratory Improvement Amendments

Claims that are submitted for laboratory services subject to the Clinical Laboratory Improvement Amendments of 1988 (CLIA) statute and regulations require additional information to be considered for payment.
N/A Products & Programs Sep 17, 2019

Test Demo for Pretend Fax

N/A Administrative Aug 21, 2019

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N/A N/A Oct 31, 2018

Notice of Material Change to Contract/Important Updates

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 N/A Oct 17, 2018

Anthem expands specialty pharmacy pre-certification list

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Pharmacy Oct 17, 2018

Anthem expands Specialty Pharmacy Clinical Site of Care (Level of Care) drug list

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Pharmacy Oct 17, 2018

Important billing update for professional delivery claims

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Administrative Oct 17, 2018

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Medical Policy & Clinical Guidelines Oct 17, 2018

New pre-certification requirement for EGD services begins November 1, 2018

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Administrative Oct 17, 2018

Update to AIM Advanced Imaging Clinical Guidelines

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Medical Policy & Clinical Guidelines Oct 17, 2018

Update to AIM Level of Care Musculoskeletal Surgery Clinical Guidelines

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Medical Policy & Clinical Guidelines Oct 17, 2018

Update to AIM Radiation Oncology Clinical Guidelines

Anthem Notices of Material Change to Contract--Important Updates - CO - August 1, 2018 Medical Policy & Clinical Guidelines Oct 17, 2018

CO Electronic Tools and Resources Migrating to the Availity Portal

TEST CO Jackie Training Administrative Jun 28, 2018

CO Amendment to Physician Agreement

CO April Newsletter _ Test Shae Administrative May 14, 2018

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N/A N/A May 8, 2018

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N/A N/A Mar 15, 2018

Behavioral Health Medication Management program clone

N/A Behavioral Health Mar 12, 2018

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Test Publication - for Colorado Reimbursement Policies Mar 12, 2018

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N/A Kim Test Category Feb 24, 2018

Shae's Test Featured Article - Medicare Advantage

Improve member medication regimen Empire and the Centers for Medicare & Medicaid Services consider medication review and reconciliation a top priority to help ensure members take their medications safely. Our pharmacists use medication review and reconciliation to help members understand what medications they are taking, why they are taking them, how they should be taking their medication and to answer any questions or concerns they have about their medication regimen.
Shae's Test Publication 2018 CO Administrative Feb 22, 2018

Shae's Test Empire’s Electronic Tools and Resources Migrating to the Availity Portal

Beginning March 16, 2018 the Empire BlueCross BlueShield (“Empire”) secure provider facility and professional portals are transitioning a majority of online tools and resources to the Availity Portal (www.availity.com). At that time, Availity will be your exclusive secure web portal to access these important Empire electronic tools and resources.
Shae's Test Publication 2018 CO Administrative Feb 22, 2018

Shae's Test Policy Update - Not registered on the Availity Portal yet?

Visit www.availity.com to register today. If you already use Availity, no additional registration is needed. Empire will appear as one of your options in the payer drop-down lists.
Shae's Test Publication 2018 CO Policy Updates Feb 22, 2018

Shae's Test Med Policy and Clinical Guidelines

Empire expands specialty pharmacy prior authorization list
Shae's Test Publication 2018 CO Medical Policy & Clinical Guidelines Feb 22, 2018

Shae's Test - Reimbursement Policies

Effective for dates of service on and after May 1, 2018, intra-articular injections of hyaluronan for the treatment of pain due to reducing and non-reducing disc displacement disease of temporomandibular joint disorders, are considered investigational and not medically necessary. No prior authorization for these agents will be required, but rather reviewed post-service.
Shae's Test Publication 2018 CO Reimbursement Policies Feb 22, 2018

Shae's Test - Products and Programs - Empire expands specialty pharmacy prior authorization list

Effective for dates of service on and after May 1, 2018, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our existing prior authorization review process.
Shae's Test Publication 2018 CO Products & Programs Feb 22, 2018

Shae's Test - P&P Behavioral Health - Hyaluronan Injections in joints other than the Knee (DRUG.00017)

Medical policy DRUG.00017 addresses the use of injections of hyaluronan in joints other than the knee, including osteoarthritis and temporomandibular joint disease. This therapy may also be referred to as viscosupplementation.
Shae's Test Publication 2018 CO Behavioral Health Feb 22, 2018

Shae's Test - P&P - Pharmacy

Revised Medical Policy Effective 11-09-2017
Shae's Test Publication 2018 CO Pharmacy Feb 22, 2018

Shae's Test - State and Federal - Medical Policy Updates

Archived Medical Policies Effective 12-27-2017 (The following policies have been archived and their content has been transferred to new Clinical UM Guidelines.)
Shae's Test Publication 2018 CO State & Federal Feb 22, 2018

Shae's Test - S&F - Federal Employee Plan (FEP)

Improve member medication regimen
Shae's Test Publication 2018 CO Federal Employee Plan (FEP) Feb 22, 2018

Shae's Test - Medicaid - New pharmacy electronic prior authorization request tool effective January 1, 2018

Empire BlueCross BlueShield HealthPlus (Empire) has partnered with CoverMyMeds to offer an electronic prior authorization (ePA) request tool that simplifies the process for requesting medications and checking the status of your submissions.
Shae's Test Publication 2018 CO Medicaid Feb 22, 2018

Shae's Test - S&F - Medicare - Availability The tool will be available beginning January 1, 2018.

These new features help simplify the prior authorization process. You will be able to:
Shae's Test Publication 2018 CO Medicare Feb 22, 2018

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N/A CalPERS Feb 13, 2018

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Test Publication - for Colorado Policy Updates Feb 7, 2018
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